MEDICARE: MADISON BARTLETT LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	34010558A	IN

General Provider Information

NPI Number	:	1750063707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON BARTLETT LCSW

Provider Business Mailing Address
First Line	:	436 HERITAGE TERRACE LN
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46032-9188
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	436 HERITAGE TERRACE LN
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46032-9188
Country	:	US
Telephone Number	:	317-417-0419
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2023
Last Update Date	:	04/27/2026

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